Treatment Issues & Responses

Informed Consent

Intercultural dynamics producing possible misunderstanding:

  1. Recitation of possible negative outcomes in some cases is believed to “call forth” negative outcome.
  2. Explanation of possible negative outcome produces loss of hope.
  3. Family expectations that elders should be protected from bad news.
  4. Family/patient answering “yes” to questions in order to show respect or not to appear foolish.
  5. Cultural family hierarchical patterns in which a family member other than the patient is expected to be the decision maker.

Techniques to minimize confusion and misunderstanding:

  1. Use cultural guides to determine acceptability of talking to older patients directly.
  2. Ask older patients if there is a preferred spokesperson.
  3. Ask patients if they would like to consult with, or appoint someone else as decision maker.
  4. Ask patients to explain in their own words what they understand about the procedure.